New-Onset Diabetes After Renal Transplantation: Diagnosis, Incidence, Risk Factors, Impact on Outcomes, and Novel Implications

Káposztás, Zsolt; Gyürüs, Éva; Kahan, B.D.

doi:10.1016/j.transproceed.2011.04.008

Cited by 27 publications

(25 citation statements)

References 126 publications

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“…30,31 According to the results of the present study, a family history of diabetes mellitus, hypertension, and smoking with frequencies of 24.1%, 16.7%, and 20.4%, respectively, were among other effective risk factors in the development of PTDM. This finding is in agreement with those of the studies carried out by Rodrigo et al and Kaposztas et al 27,32 Rodrigo et alalso reported age as one of the effective factors in NODAT 27 ; however, age was not found to be an effective factor in NODAT in the present study. This difference can be related to the fact that both groups in the present study were homogenous in terms of age.…”

Section: Discussionsupporting

confidence: 94%

Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

Ismael

Azeez

2019

Hosp Pract Res

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Background: As the rate of renal transplantation increases, more immunosuppressive drugs such as cyclosporine A (CsA) are consumed, particularly during the early months following transplantation, leading to post-transplant diabetes mellitus (PTDM) which can cause death. Objective: The present study examined the role of CsA in causing PTDM and other effective factors among patients with chronic kidney disease (CKD) who had undergone renal replacement therapy. Methods: The present investigation was a quantitative case-control study carried out on 30 CKD patients who had undergone renal transplantation and 30 healthy individuals. A questionnaire was utilized to gather their demographic information, and direct interviews were conducted with the subjects. To examine random blood sugar (RBS), white blood cell (WBC) count, creatinine level, and blood urea nitrogen (BUN), blood samples were obtained from the subjects. The mentioned parameters were analyzed using SPSS 22.0. Results: According to the results, the groups were homogenous in age, body mass index (BMI), and male-to-female ratio. However, there were significant differences between the two groups in RBS (P=0.011), WBC count (P=0.031), creatinine level (P=0.001), and BUN (P=0.001). Conclusion: Failure of allograft survival of renal transplantation was found to be a leading cause of death, which has been reportedly been treated by the consumption of immunosuppressive drugs such as CsA. However, this drug can increase the patient’s chances of developing PTDM. PTDM development can be reduced by applying a dosage of 10 mg/kg/d during the first week and 8-9 mg/kg/day during weeks 2-5 following transplantation.

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Section: Discussionsupporting

confidence: 94%

Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

Ismael

Azeez

2019

Hosp Pract Res

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“…Inadequate immunosuppression predisposes to acute cellular rejection and antidonor HLA alloantibody formation, both of which are associated with progressive interstitial fibrosis and tubular atrophy (IF/TA) and shortened graft survival (4)(5)(6). In contrast, excessive immunosuppression not only predisposes to infectious complications, but is associated with multiple toxicities including direct kidney damage (7) and indirect effects of drug-induced diabetes (8) and hypertension (9).…”

Section: Introductionmentioning

confidence: 99%

Complement as a multifaceted modulator of kidney transplant injury

Cravedi¹,

Heeger²

2014

J. Clin. Invest.

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“…Because leucine and glucose together have a synergistic effect on insulin release, they likely act through different mechanisms. New-onset diabetes has been increasingly recognized as a complication associated with organ transplantation, which creates additional challenges for patient care and likely generates significant negative impacts on long term patient survival after organ transplantation (40). Recent clinical studies revealed that NODAT is strongly associated with immunosuppressive medications (40) in which rapamycin is one of the major risk factors (19).…”

Section: Discussionmentioning

confidence: 99%

Leucine Stimulates Insulin Secretion via Down-regulation of Surface Expression of Adrenergic α2A Receptor through the mTOR (Mammalian Target of Rapamycin) Pathway

Yang

Dolinger

Ritaccio

et al. 2012

Journal of Biological Chemistry

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Background: Leucine can stimulate insulin release, but the mechanism has remained unclear. Results: Leucine regulates adrenergic ␣2 receptor trafficking. Rapamycin and clonidine together increase the risk of diabetes. Conclusion: mTOR activation by leucine elicits insulin release via adrenergic ␣2 receptors. Rapamycin and clonidine appear to synergistically facilitate new-onset diabetes. Significance: Our findings may have relevance in the clinical management of renal transplant patients.

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New-Onset Diabetes After Renal Transplantation: Diagnosis, Incidence, Risk Factors, Impact on Outcomes, and Novel Implications

Cited by 27 publications

References 126 publications

Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

Immunosuppressive Drugs and Kidney Post-transplant Diabetes Mellitus

Complement as a multifaceted modulator of kidney transplant injury

Leucine Stimulates Insulin Secretion via Down-regulation of Surface Expression of Adrenergic α2A Receptor through the mTOR (Mammalian Target of Rapamycin) Pathway

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